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Flashcards in EMS Anatomy Lab Deck (40)
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1

Introduction

- Introduce Self. Biology. Medicine. Anatomy.
- State Anatomical Board vs. Organ Donation
- Worried about infection? Screened for HIV and Hepatitis
- State board gives bodies to Universities, and 2 to EMS (This program)
- Dissection takes 8 hours; dissection program every 6 months.
- Family member gets cremation remains.
- Every spring University of Colorado Health and Sciences Center holds a Memorial Service. Tree or bench is donated in their memory.
- Very grateful to have an opportunity to learn from them even after they passed.
- Who's nervous? Gift so that we can learn. Signing up for body donation, they know exactly what they are in for. Every year, the board comes back to them and they asks them for confirmation. Family vetoes.

2

Rules

- Goggles and gloves. Vicks in the tub.
- If you need to throw gloves away, throw it in the red biohazard bin, and not the trash can.
- Girls with long hair, I highly recommend you to tie them up.
- No food/ no drink.
- Next rule is a big one for me. No cell phones. Have to maintain our respect for our cadaver.
- Who's fainted before? Fainting is when there is lack of blood and oxygen to the brain. Symptoms: dizzy, dimming vision, hot. If you begin to feel any of that, immediately sit on the ground. Because if you fall off your stool and hit your head on the ground, you have to go to the ER for the night.
- If you need to step outside the room, you have to leave with a partner.

3

Observations

- 1st thoughts? How does it look? As expected? Hands, feet, and face covered? 1) ID 2) Less personal.
- Expectations? Gender? Height? Weight?
- Notice anything about the body? Stitch? Embalming fluid- the flush body and remove any infectious agents. It also destroys pigment and liquefies fat.Cadaver wrinkles. Causes color and texture changes.
- Also preserve body with 2% formaldehyde, alcohols (methanol, phenol, glycerol), and water.
- What do you notice about the skin? Shiny? Glycerol from saponification. Making soap and glycerol from fat; Base (metallic alkali) and fat= soap!
- Do hair and nails grow after death? No! Epidermis pulls it in.

4

Skin

- What is the largest organ in the body? Skin!
- Weight about 10-20 pounds in an average 150 lb man.
- Functions? Protection from infection, dehydration, temp regulation,and sensation.
- Sweat up to 4 pints/ hour.
- Layers of the skin? Epidermis. Come, Lets Get Sun Burned. Corneum, Lucidum, Granulosum, Spinosum, and Basale. Dermis and Hypodermis.
- Where is Skin cancer found? Epidermis. Cancer facts: most common form of cancer in US. Over two million people are diagnosed with it every year. Each year there are more new cases of skin cancer than combined incidence of cancers of the breast, prostate, lung, colon.
- Most common type? Basal cell carcinoma- slow growing, rarely metastasizes.
- Most deadly? Melanoma. Starts in melanocytes. Difference between races.
- How do you avoid damage to skin? Stay out of sun and beds. One session of tanning in bed increases your chance for skin cancer by about 20%. And every session thereafter, increases it by 2%.
- Seborrheic Keratosis. Barnacles of Life. Liver spots- solar lentigo.
- Dermis- Dense connective tissue. Stitching. Nerves and BV, and glands (sweat and sebaceous glands). Acne.
- Hypodermis. Fat for cushion, insulation, and energy storage.
- Burns. 1st degree, epidermis, sunburn, HURTS! 2nd degree- dermis- blisters- HURTS! 3rd- hypodermis, require graft and special burn units- hurts? trick.

5

Bones

- Adults: 206, Baby: 350. Fusion.
- Ribs: 12 sets.
- Vertebrae: 7, 12, 5. Spinous processes and transverse processes.

6

Chest Wall

- Thoracic and Abdominal Cavity are covered by double layer of wrappers called Fascia. Function: Compartmentalize, stabilize, and protect organs. 2 layers: parietal and visceral. Subway.
- Sternum: manubrium, body, and xyphoid process. CPR, xiphoid breaks and ribs break, what do you do? Compression!
- Abdominal Wall: Rectus abdominis- crunches. External and internal obliques. Transverse abdominis- suck stomach in.

7

Tongue

- Taste buds. Swallow- also make bolus of food so that its easy to swallow.
- Many muscles associated with tongue: Extrinsic muscles which are attached to other structures. Instrinsic tongue= alter shape of tongue; lengthening and shortening. Rolling tongue is genetic.
- Sublingual gland- 1; major salivary gland.
- Parotid glands- 2; cheeks.
- 2 submandibular glands.

8

Tonsils

Tonsils: Lymphoid tissue, part of immune system, might help upper respiratory tract infection. First line of defense.

9

Hyoid Bone

Broken when strangled.

10

Lungs/Airways

Uvula, epiglottis (flap that covers the airway when we swallow), nasopharynx (filters and warms air), oropharynx (air and food).

11

Cartilage

-Thyroid Cartilage: Adam's apple.
-Below that you have your thyroid gland. Secretes T3 (active) and T4 (inactive) to metabolism. HYPER= Graves (treat with suppressive thyrostatics, surgical or radioisotope therapy). HYPO= Hashimoto.
-Cricoid cartilage: C-rings of the trachea, swallow penny.
- Vocal cords: false and true. In males, testosterone creates longer vocal cords --> low note.
-Tracheotomy: superior or inferior to the isthmus of the thyroid gland. Function: to bypass an obstructed upper airway; to clean and remove secretions from the airway;
to more easily, and usually more safely, deliver oxygen to the lungs.
- General area where people choke on food. Heimlech.

12

Lungs

- Trachea divides into the bronchi, bronchioles, and alveoli. Which leads us to the lungs.
- Lobes: 2 left, 3 right. Why 2 on left?
- What is the purpose of alveoli? 300-400 million-- Why? increase SA, 1/2 size of a football field.
- Diaphragm
- Breathing: take in about 6 L of air each minute. Controlled by medullary respiratory center. Stimulated by low O2 and high pH in the blood. Normal pH of blood is 7.4.
- Smoking. Smoking 1 pack per day collects about 5 oz of nicotine yearly. Half of all long term smokers will die a tobacco related death. Think shes a smoker?
- Lung cancer is the leading cause of cancer death ) colon and breast follows). Smoking increases your risk 10-25x of developing bronchial carcinoma (cancer epithelium). Get this: 10-15 years after quitting poses no increased risk.
- Score smokers via pack year: number of packs/ day x number of years smoking. Dad had a 30 pack year, 1 pack a day for 30 years.

13

Lung Diseases

- Emphezema: alveoli wall breaks down, brochioles collapse in exhalation, less surface area, less elastic recoil. Barrel chest. "pink puffers"
- Bronchitis: chronic inflammation of the bronchi. "blue bloaters" because they become cyanotic. Persistent cough, sputum, and mucus.
- COPD: Airways narrowed, limited air flow to the lungs. As a result shortness of breath. Commonly coexists with bronchitis and emphezema.
- Asthma: bronchi restricts. Reversible. Tx: inhaled corticosteroids and then long acting beta2 agonists to help open the airway.
- Pneumonia: alveolar inflammation and alveolar filling with fluid. Symptoms: cough, chest pain, difficulty breathing. Main cause of death in elderly.
- Tuberculosis: Infectious disease- 75% pulmonary, but can affect other parts of the body. Victorian blue house.

14

Esophagus

- Muscle Types
- Upper 1/3 skeletal and lower 2/3 smooth.
- Peristalsis: waves of contraction and relaxation.
- Cardiac sphincter (b/c by heart)= not true muscle. Heart burn: stomach acid gets into esophagus.

15

Stomach

- Function: Protein digestion: mechanical and chemical breakdown of bolus into chyme, semifluid mass to get expelled into small intestine.
- Main cells: parietal (HCL) and Chief cells (pepsinogen and bicarbonate).
- Structures: Rugae for expansion- hold 2-3 L food.
- Gastric Ulcers: most common in duodenum, 10% stomach. Treat NSAIDS or corticosteroids or antibiotics.
- Pyloric sphincter: where stomach attaches to duodenum, control amount of chyme entering.
- Gastric by pass (stomach and duodenum is bypassed) change how GI handles your food.
- Gastric Banding: Lab band on upper pouch leaving lower larger remnant. BMI >40. Inflatable silicone placed on top portions. Laparoscopic surgery. Upper part of stomach thinks its full.

16

Hair Jar

- What are some things that stomach cannot digest? Wood, fiber, metals, hair.
- 30 years ago we had a patient that came in vomiting. Took image and found a dense mass. Turned out she had a stomach full of hair. Why? Tricho-philo-mania, and Tricho-philo phagia. So here we have a bezoar= our ball of undigested materials.

17

Small Intestine

- 4-5x longer than intestine, but smaller diameter.
- 21 feet
-Attached to mesentary, folds of peritoneum that attaches to the stomach, small intestine, spleen, pancreas, and to the back so that it stays anchored. Also gives bowel great mobility.
- 95% of nutrients get absorbed here. Inside projections called villi that stick out the walls of the small intestine. Nutrients diffuse through into blood.
- Three parts: Duodenum (10') (Breakdown, Brunners glands for mucus, CCK tells gall bladder/ liver to contract and release bile to emulsify fat, Secretin for pancreas to release sodium bicarbonate and digestive enzymes) Jejunum: (8') plicae circularis to increase SA.
Ileum: mainly absorbs vit B12 and bile salts. Has Peyer's patches (organized lymphoid tissue unique to ileum).
- Iliocecal valve/ sphinctor

18

Large Intestine

- Vitamin, water/ Na (sodium) absorption.
- Colon= ascending, transverse, descending, sigmoid + cecom and rectum
- Cecum is the start of LI. Pouch connected to ascending colon.
- Vermiform appendix: harvests good bacteria. Vestigial structure. Immune Use.
- Fecolith, causes blockage. Inflammation.

19

Pancreas:

Two Functions: Exocrine: digestive enzymes for fat and protein. Also releases bicarbonate. Sits the curve of duodenum. Pancreasitis.
Endocrine: Insulin from the beta-cells. It is released whe you are well -fed. Signals liver and muscles to take up glucose and store as glycogen. Glucagon (alpha cells)- fasting- release glucose from liver, muscle (and fat).
Diabetes Mellitus: get hyperglycemia- abnormally high blood sugar levels.
Type I: autoimmune- diminished production of insulin.
Type II: acquired- develop resistance to insulin- diet and exercise for prevention.
Gestational: Inadequate insulin secretion and responsiveness. In all cases, give insulin.
Signs of diabetes: excessive thirst and urine production, blurred vision, unexplained weight loss, lethargy, changes in energy metabolism.
Complications: Acute: ketoacidosis, hypoglycemia, and diabetic coma. Chronic: CVD doubled, chronic renal failure, retinal damage (blindness); nerve damage (neuropathy), poor wound healing.
Diabetes insipidus: excessive thirst and excretion of diluted urine. Kidney damage and pituitary gland damage.

20

Gall Bladder

- Stores bile made in the liver (0.5L/day)
- Bile- emusifies fat- helps excrete bilirubin and cholesterol. Fat broken down into droplets
- Gall stone jar: 20% of Western population; formation of cholesterol rich stones: cholesterol, phospholipids, and bile salts. Issues with bile concentration and how often the gall bladder contracts.
Risk factors:

21

Liver

- Largest internal organ and gland in the body.
- Functions: metabolism, storage, processing of nutrients, clotting factors, and production of bile.
- Hepatitis A: resolves itself- fecal oral route contamination. Vomiting and diarrhea.
Hepatitis B: acute: nothing. chronic: may never go away. Vaccine.
Hep C: liver failure at end, transmitted via blood and body fluids. (Scarring of liver).
Cirrhosis: alcohol and hepatitis create scarring in liver- blood flow is restricted. 80% loss of hepatocytes before failure.
Severe disease: jaundice, bruises easily, ankle sweeling, lethargy, dilated esophageal varices (dilated vessels due to back flow from liver)

22

Spleen

- Lymph node of immune system
- Filters old RBC/ PLT
- When you have an infection, be wary of sports because rupture with trauma. Bleed to death if not caught early.

23

Kidney

-Fat protects
Renal artery and veins, cortex, medulla w/ pyramids, major and minor calyxes, renal pelvis, and ureter.
-Function: Maintain homeostatic balance of bodily fluids by filtering and secreting metabolites and minerals from the blood and excreting them along with water. (urine)
- Regulators of BP: EPO- stimulates RBC production.
- Exchanges total blood volume (4-5L) 1x per hour.
- The filters are nephrons (1 million of them in each kidney)
- Glomerulus (filters the blood) and Loop of Henle (H20 follows)
- ADH concentrates hormones
- EtOH and caffeine decreases ADH- increase urine output.
Adrenal glands:aldosterone and glucocorticoids.

24

Bladder

Stores urine (2 ureters to bladder). 5oz urge, hold 3- 4 cups of urine. Internal and external sphincters- kegel exercises. UTI: feces, e.coli close to the bladder. Urethra 4 cm women, 20 cm in men.

25

Heart

-Epicardium: parietal and viscera
-Facts: 5 L/ min 100,000 beats per day. I minute for RBC to circle the whole entire body. and it will make about 250,000 round trips before to goes to die. 120 days.
-Blood Flow: Vena cava, RA, Tri, RV, pulmonic valve (semi-lunar), pulmonary a, lungs, pulmonary v, LA, bicuspid, LV, aortic valve, aorta.
-Valves are like little leaflets attached to chordinae tendinae to prevent backflow. Papillary muscles- contract in systole to hold the valves closed,
-Has own conduction: SA/ AV node bundle of his, purkinje fibers.
-Coronary blood flow.
-Problems: myocardial infraction (heart attack) from clogged arteries. Plaque or thrombus (blood clot). -Bypass surgery: veins from leg.
-Fibrillation: atria and ventricles dont work together.
-Defibillation: hope to restart the SA node again.
Pace maker to treat arrythmias: device uses low-energy electrical pulses to prompt the heart to beat at a normal rate. through subclavian vein- SVC and into RV.

26

Shoulder

-Modifed ball and socket
- Scapula, humerus, clavicle
- Muscles: deltoid, trapezius, lattisumus dorsi, pectoralis
- SITS: supra/infra, teres minor, and subscapularis.

27

Arm

Muscles: biceps brachii, brachialis, and triceps.

28

Elbow

Hinge joint
Ulnar nerve
Forearm: flexors and extensors pronators and supinators.

29

Hip

Ball and socket
Femur, head with fovea, greater trochanter, neck
Hip Replacement: seen in post-menopausal women and those with osteoporosis
Sciatic Nerve- Longest and widest single nerve in the body- leg goes numb.
Scaitica- back and leg pain, rather than a diagnosis.

30

Calf

Gastrocnemius, Soleus, Achilles Tendon